The ultimate aim of genetic research is to improve human health and prevent disease. One key measure of success in translating new genetic knowledge into improved health will be the extent to which genomic medicine reduces existing health disparities. We propose to develop a CEER on "Genetics, Vulnerable Populations and Health Disparities" dedicated to examining the complex intersection of emerging genetic research and the persistent problem of health disparities through in-depth analysis of 3 key clinical areas: tobacco dependence, asthma, and diabetes. Each of these conditions is marked by high prevalence (together, these conditions affect 85M (29%) of Americans), persistent health disparities (by race/ethnicity and socioeconomic status) and significant genetic findings related to disease etiology and/or response to treatment. Genomic advances in the treatment and prevention of these conditions - appropriately applied in clinical practice - would thus have far-reaching potential to improve not only our nation's health, but also to reduce existing health disparities across racial/ethnic and socioeconomic lines. Specific aims are: (1) to identify and prioritize key ELSI issues related to the conduct, communication and translation of genetic research on tobacco dependence, asthma and diabetes; (2) develop a research agenda to address these concerns; (3) analyze high priority, policy-relevant issues (through 3-4 papers) to inform ongoing policy discussions and lay the groundwork for future research; (4) develop the capacity to monitor the equitable diffusion of emergent genetic-based treatments across racial/ethnic communities and Medicaid vs. privately insured individuals in the U.S. through completion of a feasibility study; (5) collect appropriate pilot data (e.g. focus groups, key informant interviews) to inform the P5O Center proposal; (6) provide training for a minority graduate student and develop a training component to encourage new ELSI investigators from underrepresented minority communities; and (7) submit a competitive P50 CEER proposal.